Abstract
Background: An episiotomy is a surgical obstetric intervention that is considered when a high risk of a third- or fourth-degree laceration or a concerning fetal heart tracing necessitating an expedite vaginal delivery. Objectives:Episiotomy is an important procedure in the clinical practice of many obstetricians, therefore, in this paper, we will review the proper literature discussing indications, risk factors, complications, and management of episiotomy. Methodology: PubMed database was used for articles selection, and the following keys were used in the search: episiotomy, indications, risk factors, complications. Review:An increased risk of perineal injury and wound-healing complications favors the restricted use of episiotomy. The judgment to perform episiotomy should be made on a case-by-case, although episiotomy may be helpful in some clinical settings. Technique-wise, a mediolateral approach is favored over a median one due to the lower risk of anal sphincter laceration. Infections, pain, and dyspareunia are among the most reported complications of episiotomy. Future vaginal delivery might become complicated due to a previous episiotomy. Conclusion: Knowledge of the indications, risk factors, and subsequent short- and long-term complications is vital to any practicing obstetrician.